In the latest ASCO in Action Podcast, Manali Patel, MD, MPH, joined ASCO CEO Dr. Clifford A. Hudis to discuss ASCO’s position statement on Medicaid work requirements, which addresses state waivers submitted to the Centers for Medicare & Medicaid Services (CMS) that, if approved, would make Medicaid eligibility, continued coverage, cost-sharing, and other program benefits dependent on a beneficiary’s work status. These Medicaid waivers will hinder patient access to essential cancer care, asserts ASCO’s position statement, and increase administrative burden on physicians by requiring them to verify a patient’s work status, thereby reducing the already limited time physicians spend with their patients.
During the podcast discussion, Chair-elect of ASCO’s Health Equity Committee Dr. Patel shares her concerns with the proposed Medicaid waivers, saying that while—historically—waivers were meant to expand eligibility, waivers are now being used to directly inhibit access. Disruptions in care, delay in treatment, and other gaps in care delivery have been shown to adversely impact cancer care outcomes and “to think that these disruptions are now being imposed into Medicaid eligibility requirements is quite concerning,” she says.
Dr. Patel stresses that many patients with cancer have no choice but to stop working entirely during their treatment due to the impact of their disease and/or treatment side effects.
The proposed changes in Medicaid eligibility could also have a significant financial impact on beneficiaries by requiring patients to provide additional cost-sharing and pay premiums for services they receive through Medicaid. While Medicaid and the percentage of cost-sharing varies by state, some of the proposed cost-sharing expenses would be up to 50% of services provided.
“It comes as a shock that we would expect patients who would be eligible for Medicaid, given the provisions of what Medicaid has been there to serve and has been enacted to serve, that we’re seeing patients experience the financial toxicity perhaps even more so than patients that may be in private health plans,” says Dr. Patel.